Ebola virus disease

Talk given in our Port said fifth neonatology conference 23-24 October 2014, by Dr. Kamal Fayez El Tohami Professor of Pediatrics Al Azhar University

1. ميحرلا نمحرلا لا مسب

2. Ebola virus disease
Dr. Kamal Fayez El Tohami
Professor of Pediatrics
Al Azhar University - Cairo

3. Agenda
•What is Ebola
•Symptoms of Ebola
•Transmission
•Risk
•Prevention
•Diagnosis
•Treatment

4. Ebola virus disease
•Ebola virus disease (EVD), Ebola hemorrhagic
fever (EHF), or simply
•Ebola is a disease of humans and other primates
caused by an ebola virus.
• Symptoms start two days to three weeks after
contracting the virus, with a fever, sore throat,
muscle pain and headaches. Typically, vomiting
, diarrhea and rash follow, along with decreased
functioning of the liver and kidneys.
•Around this time, affected people may begin
to bleed both within the body and externally

6. Transmission

7. Transmission
•Because the natural reservoir host of Ebola
viruses has not yet been identified, the manner
in which the virus first appears in a human at the
start of an outbreak is unknown.
•However, researchers believe that the first
patient becomes infected through contact with an
infected animal.

8. Transmission
•When an infection does occur in humans, the virus
can be spread in several ways to others.

9. Transmission
·
Healthcare providers caring for Ebola patients and the
family and friends in close contact with Ebola patients are
at the highest risk of getting sick because they may come
in contact with infected blood or body fluids of sick
patients.
·
During outbreaks of Ebola, the disease can spread quickly
within healthcare settings (such as a clinic or hospital).
·
Exposure to Ebola can occur in healthcare settings where
hospital staff are not wearing appropriate protective
equipment, including masks, gowns, and gloves and eye
protection.

10. Risk of Exposure
•Ebola viruses are found in several African
countries.
•Ebola was first discovered in 1976 near the
Ebola River in what is now the Democratic
Republic of the Congo.
•Since then, outbreaks of Ebola among humans
have appeared sporadically in Africa.
•It can affect all age groups.

11. Ebola Outbreaks
•Ebola outbreaks have occurred in the following
countries:
·
Democratic Republic of the Congo (DRC)
·
Gabon
·
South Sudan
·
Ivory Coast
·
Uganda
·
Mali
·
Republic of the Congo (ROC)
·
South Africa

12. Risk
•All cases of human illness or death from Ebola have
occurred in Africa (one in England and two in
Russia). One case had been reported in the United
States.

13. Prevention
•There is NO FDA-approved vaccine available
for Ebola.
•If you travel to or are in an area affected by
an Ebola outbreak, make sure to do the
following:
·
Practice careful hygiene.
·
Avoid contact with blood and body fluids.
·
Avoid funeral or burial rituals that require
handling the body of someone who has died
from Ebola

14. Prevention
·
Avoid contact with bats and nonhuman primates
or blood, fluids, and raw meat prepared from
these animals.
·
Avoid hospitals where Ebola patients are being
treated.
·
After you return, monitor your health for 21 days
and seek medical care immediately if you
develop symptoms of Ebola.

15. Prevention
•Healthcare workers who may be exposed to people
with Ebola should follow these steps:
·
Wear protective clothing, including masks,
gloves, gowns, and eye protection.
·
Practice proper infection control and sterilization
measures.
·
Isolate patients with Ebola from other patients.

16. Prevention
•Avoid direct contact with the bodies of people who
have died from Ebola.
·
Notify health officials if you have had direct contact
with the blood or body fluids, feces, saliva, urine,
vomit, and semen of a person who is sick with
Ebola.

17. Diagnosis
•Diagnosing Ebola in an
person who has been
infected for only a few days
is difficult, because the early
symptoms, such as fever,
are nonspecific to Ebola
infection and are seen often
in patients with more
commonly occurring
diseases, such as malaria
and typhoid fever.

18. Diagnosis
•However, if a person has the early symptoms of
Ebola and has had contact with the blood or
body fluids of a person sick with Ebola, they
should be isolated and public health
professionals notified.
•Samples from the patient can then be collected
and tested to confirm infection.

19. Laboratory tests used in diagnosis include
•Within a few days after symptoms begin
·
Antigen-capture enzyme-linked immunosorbent
assay (ELISA) testing
·
IgM ELISA
·
Polymerase chain reaction (PCR)
·
Virus isolation

20. Laboratory tests used in diagnosis include
•Later in disease course or after recovery
·
IgM and IgG antibodies
•Retrospectively in deceased patients
·
Immunohistochemistry testing
·
PCR
·
Virus isolation

21. Treatment
•No specific vaccine or medicine (e.g., antiviral drug)
has been proven to be effective against Ebola.
·
Providing intravenous fluids (IV) and balancing
electrolytes
·
Maintaining oxygen status and blood pressure
·
Treating other infections if they occur

22. Treatment
•Some experimental treatments developed for Ebola
have been tested and proven effective in animals but
have not yet been tested in randomized trials in
humans.
•Recovery from Ebola depends on the patient’s
immune response.
•People who recover from Ebola infection develop
antibodies that last for at least 10 years, possibly
longer.

23. Experimental Treatments and Vaccines for Ebola
•What is ZMapp?
•ZMapp, being developed by Mapp
Biopharmaceutical Inc., is an experimental
treatment, for use with individuals infected with
Ebola virus.
•It has not yet been tested in humans for safety or
effectiveness.
•The product is a combination of three different
monoclonal antibodies that bind to the protein of the
Ebola virus so that the human immune system can
clear the virus.

24. Experimental Treatments and Vaccines for Ebola
•Are there other companies developing experimental
treatments or vaccines?
•Two other companies,
–Tekmira is working with a company called
Newlink to develop an Ebola vaccine candidate.
–BioCryst, with NIH support, is working to develop
an antiviral drug to treat Ebola virus that is
expected to begin Phase 1 testing later this year.

25. Take Home Message
•Ebola is a lethal disease
•It affects all age groups
•It is transmitted through body fluids and contact to
an infected animal or person
•Prevention is through isolation and means of
disinfectant and sterilization
•Treatment uptilnow is supportive
•No valid vaccine or antiviral are available yet

26. Thanks
Dr. Kamal Fayez El Tohami
Professor of Pediatrics
Al Azhar University - Cairo